Health systems around the world are reaching a tipping point – the rising need for health care of an aging population, emerging problems like Ebola and persistent problems like malaria and tuberculosis, and the recent Covid pandemic all highlight the limitations of our healthcare systems and their prevailing models of organization. While there is increasing awareness of the risks to our health systems there is little evidence of starting the necessary widespread engagement with all stakeholders to deal with this ‘wicked problem’.
The status quo in a nutshell – the hospital-centric focus with its emphasis on curing diseases has resulted on the one hand in its financial unsustainability, and on the other in patients’ distrust in being able to receive the right care at the right point in time that meets their needs. The focus on disease management of the common chronic disease spectrum provides a never-ending business opportunity driven by ongoing investigations and interventions of questionable benefits. There are no funds left to address the ’causes of the causes’, and to invest in improving the social determinants of health like secure work and employment, safe housing and urban communities, health foods and community gardens, and education and learning support. These activities are essential to reduce the stress mediated psychoneuroimmunological drivers that cause and perpetuate disease.
The exploitative nature of the healthcare market has finally made the health system precariously unstable – health services can’t afford staff and equipment, and patients can’t afford the direct and/or indirect costs of healthcare.
We have a window of opportunity to prepare for the inevitable need for change. This year’s meeting will focus on the systemic bottom-up redesign of health systems. Hence, we invite all health system stakeholders – spanning from urban design, education, finance, public health, healthcare, community members to basic scientists – to come to San Francisco to share their insights into ways to rebuild health system harnessing our diversity for the creation of an inclusive and sustainable health system.
